After ICMR Expands Use Of Hydroxychloroquine, International Study Sounds A Caution

The Indian Council Of Medical Research (ICMR) on Friday expanded the use of the anti-malarial drug Hydroxychloroquine (HCQ) as a preventive treatment against coronavirus. At the same time, leading medical journal, The Lancet has published a study which states that "there is no evidence of benefit for chloroquine and hydroxychloroquine in COVID-19 patients and that urgent randomised trials are needed". The study also found the use of hydroxychloroquine linked to increased rates of mortality among hospital patients with COVID-19.

The ICMR’s revised guidelines recommended the prophylactic use of HCQ in the following categories:

1. All asymptomatic healthcare workers involved in containment and treatment of COVID19 and asymptomatic healthcare workers working in non-COVID hospitals/non-COVID areas of COVID hospitals/blocks

2. Asymptomatic frontline workers, such as surveillance workers deployed in containment zones and paramilitary/police personnel involved in COVID-19 related activities.

3. Asymptomatic household contacts of laboratory confirmed cases.

It has at the same time  flagged potential harm in people with underlying conditions.

The advisory also stated that “At NIV, Pune, the report of the in-vitro testing of HCQ for antiviral efficacy showed reduction of infectivity /log reduction in viral RNA copy of SARs-CoV2”.

However, the study published in The Lancet analysed data from nearly 15,000 patients with COVID-19 receiving a combination of any of the four drug regimens and 81,000 controls.

“Treatment with these medications among patients with COVID-19, either alone or in combination with macrolide antibiotics, was linked to an increased risk of serious heart rhythm complications in these patients”, the study stated.

Hydroxychloroquine is also used to treat autoimmune diseases including lupus and arthritis, where it has good safety profile.

Professor Dr Mandeep R. Mehra, lead author of the study and Executive Director of the Brigham and Women’s Hospital Center for Advanced Heart Disease in Boston, USA, said: “This is the first large scale study to find statistically robust evidence that treatment with chloroquine or hydroxychloroquine does not benefit patients with COVID-19. Instead, our findings suggest it may be associated with an increased risk of serious heart problems and increased risk of death. Randomised clinical trials are essential to confirm any harms or benefits associated with these agents. In the meantime, we suggest these drugs should not be used as treatments for COVID-19 outside of clinical trials.”